Organization
SAN TAN MOBILE DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT LUBBEN (PRESIDENT)
(928) 362-0979
Entity
Organization
Contact information
Practice address
1457 W SOUTHERN AVE, SUITE 24, MESA, AZ 85202-4813
(928) 362-0979
(480) 999-5641
Mailing address
1457 W SOUTHERN AVE, SUITE 24, MESA, AZ 85202-4813
(928) 362-0979
(480) 999-5641
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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